Aortic sclerosis pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
Calcific aortic valve disease includes both [[aortic sclerosis]] and [[aortic stenosis]]. | [[Calcific aortic valve disease]] includes both [[aortic sclerosis]] and [[aortic stenosis]].<ref name="pmid16709942">{{cite journal |author=O'Brien KD |title=Pathogenesis of calcific aortic valve disease: a disease process comes of age (and a good deal more) |journal=[[Arteriosclerosis, Thrombosis, and Vascular Biology]] |volume=26 |issue=8 |pages=1721–8 |year=2006 |month=August |pmid=16709942 |doi=10.1161/01.ATV.0000227513.13697.ac |url=http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=16709942 |accessdate=2012-04-11}}</ref> | ||
In patients with calcific aortic valve disease, microscopic examination reveals lipoprotein accumulation,<ref name="pmid8624774">{{cite journal |author=O'Brien KD, Reichenbach DD, Marcovina SM, Kuusisto J, Alpers CE, Otto CM |title=Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of 'degenerative' valvular aortic stenosis |journal=[[Arteriosclerosis, Thrombosis, and Vascular Biology]] |volume=16 |issue=4 |pages=523–32 |year=1996 |month=April |pmid=8624774 |doi= |url=http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=8624774 |accessdate=2012-04-11}}</ref> macrophage and T-cellular infiltration,<ref name="pmid8144784">{{cite journal |author=Olsson M, Dalsgaard CJ, Haegerstrand A, Rosenqvist M, Rydén L, Nilsson J |title=Accumulation of T lymphocytes and expression of interleukin-2 receptors in nonrheumatic stenotic aortic valves |journal=[[Journal of the American College of Cardiology]] |volume=23 |issue=5 |pages=1162–70 |year=1994 |month=April |pmid=8144784 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(94)90606-8 |accessdate=2012-04-11}}</ref> basement membrane disruption and extracellular matrix formation that lead to progressive thickening of the aortic valve.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref><ref name="pmid7519131">{{cite journal |author=Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O'Brien KD |title=Characterization of the early lesion of 'degenerative' valvular aortic stenosis. Histological and immunohistochemical studies |journal=[[Circulation]] |volume=90 |issue=2 |pages=844–53 |year=1994 |month=August |pmid=7519131 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=7519131 |accessdate=2012-04-11}}</ref><ref name="pmid16709942">{{cite journal |author=O'Brien KD |title=Pathogenesis of calcific aortic valve disease: a disease process comes of age (and a good deal more) |journal=[[Arteriosclerosis, Thrombosis, and Vascular Biology]] |volume=26 |issue=8 |pages=1721–8 |year=2006 |month=August |pmid=16709942 |doi=10.1161/01.ATV.0000227513.13697.ac |url=http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=16709942 |accessdate=2012-04-11}}</ref> | In patients with calcific aortic valve disease, microscopic examination reveals lipoprotein accumulation,<ref name="pmid8624774">{{cite journal |author=O'Brien KD, Reichenbach DD, Marcovina SM, Kuusisto J, Alpers CE, Otto CM |title=Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of 'degenerative' valvular aortic stenosis |journal=[[Arteriosclerosis, Thrombosis, and Vascular Biology]] |volume=16 |issue=4 |pages=523–32 |year=1996 |month=April |pmid=8624774 |doi= |url=http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=8624774 |accessdate=2012-04-11}}</ref> macrophage and T-cellular infiltration,<ref name="pmid8144784">{{cite journal |author=Olsson M, Dalsgaard CJ, Haegerstrand A, Rosenqvist M, Rydén L, Nilsson J |title=Accumulation of T lymphocytes and expression of interleukin-2 receptors in nonrheumatic stenotic aortic valves |journal=[[Journal of the American College of Cardiology]] |volume=23 |issue=5 |pages=1162–70 |year=1994 |month=April |pmid=8144784 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(94)90606-8 |accessdate=2012-04-11}}</ref> basement membrane disruption and extracellular matrix formation that lead to progressive thickening of the aortic valve.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref><ref name="pmid7519131">{{cite journal |author=Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O'Brien KD |title=Characterization of the early lesion of 'degenerative' valvular aortic stenosis. Histological and immunohistochemical studies |journal=[[Circulation]] |volume=90 |issue=2 |pages=844–53 |year=1994 |month=August |pmid=7519131 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=7519131 |accessdate=2012-04-11}}</ref><ref name="pmid16709942">{{cite journal |author=O'Brien KD |title=Pathogenesis of calcific aortic valve disease: a disease process comes of age (and a good deal more) |journal=[[Arteriosclerosis, Thrombosis, and Vascular Biology]] |volume=26 |issue=8 |pages=1721–8 |year=2006 |month=August |pmid=16709942 |doi=10.1161/01.ATV.0000227513.13697.ac |url=http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=16709942 |accessdate=2012-04-11}}</ref> | ||
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:#Regions of the fibrosa adjacent to these lesions were characterized by thickening and by protein, lipid, and calcium accumulation | :#Regions of the fibrosa adjacent to these lesions were characterized by thickening and by protein, lipid, and calcium accumulation | ||
*Aortic sclerosis is '''''non-obstructive degeneration''''' of the aortic valve developed consequently to calcification of the aortic valve and macrophage accumulation which is dependent on the synthesis of osteopontin protein.<ref name="pmid7554197">{{cite journal |author=O'Brien KD, Kuusisto J, Reichenbach DD, Ferguson M, Giachelli C, Alpers CE, Otto CM |title=Osteopontin is expressed in human aortic valvular lesions |journal=[[Circulation]] |volume=92 |issue=8 |pages=2163–8 |year=1995 |month=October |pmid=7554197 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=7554197 |accessdate=2012-04-11}}</ref> | *Aortic sclerosis is '''''non-obstructive degeneration''''' of the aortic valve developed consequently to [[calcification of the aortic valve]] and macrophage accumulation which is dependent on the synthesis of osteopontin protein.<ref name="pmid7554197">{{cite journal |author=O'Brien KD, Kuusisto J, Reichenbach DD, Ferguson M, Giachelli C, Alpers CE, Otto CM |title=Osteopontin is expressed in human aortic valvular lesions |journal=[[Circulation]] |volume=92 |issue=8 |pages=2163–8 |year=1995 |month=October |pmid=7554197 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=7554197 |accessdate=2012-04-11}}</ref> | ||
==References== | ==References== | ||
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[[Category:Disease]] | |||
[[Category:Cardiology]] | |||
Revision as of 16:49, 11 April 2012
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Aortic sclerosisMicrochapters |
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Aortic sclerosis pathophysiology On the Web |
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Risk calculators and risk factors for Aortic sclerosis pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Calcific aortic valve disease includes both aortic sclerosis and aortic stenosis.[1]
In patients with calcific aortic valve disease, microscopic examination reveals lipoprotein accumulation,[2] macrophage and T-cellular infiltration,[3] basement membrane disruption and extracellular matrix formation that lead to progressive thickening of the aortic valve.[4][5][1]
Pathophysiology
- Otto et al,[5] demonstrated the following histological characteristics observed in patients with aortic sclerosis:
- Subendothelial thickening on the aortic side of the leaflet, between the basement membrane and elastic lamina
- Presence of large amounts of intracellular and extracellular neutral lipids and fine, stippled mineralization
- Disruption of the basement membrane overlying the lesion
- Regions of the fibrosa adjacent to these lesions were characterized by thickening and by protein, lipid, and calcium accumulation
- Aortic sclerosis is non-obstructive degeneration of the aortic valve developed consequently to calcification of the aortic valve and macrophage accumulation which is dependent on the synthesis of osteopontin protein.[6]
References
- ↑ 1.0 1.1 O'Brien KD (2006). "Pathogenesis of calcific aortic valve disease: a disease process comes of age (and a good deal more)". Arteriosclerosis, Thrombosis, and Vascular Biology. 26 (8): 1721–8. doi:10.1161/01.ATV.0000227513.13697.ac. PMID 16709942. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help) - ↑ O'Brien KD, Reichenbach DD, Marcovina SM, Kuusisto J, Alpers CE, Otto CM (1996). "Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of 'degenerative' valvular aortic stenosis". Arteriosclerosis, Thrombosis, and Vascular Biology. 16 (4): 523–32. PMID 8624774. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help) - ↑ Olsson M, Dalsgaard CJ, Haegerstrand A, Rosenqvist M, Rydén L, Nilsson J (1994). "Accumulation of T lymphocytes and expression of interleukin-2 receptors in nonrheumatic stenotic aortic valves". Journal of the American College of Cardiology. 23 (5): 1162–70. PMID 8144784. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help) - ↑ Freeman RV, Otto CM (2005). "Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies". Circulation. 111 (24): 3316–26. doi:10.1161/CIRCULATIONAHA.104.486738. PMID 15967862. Retrieved 2012-04-10. Unknown parameter
|month=ignored (help) - ↑ 5.0 5.1 Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O'Brien KD (1994). "Characterization of the early lesion of 'degenerative' valvular aortic stenosis. Histological and immunohistochemical studies". Circulation. 90 (2): 844–53. PMID 7519131. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help) - ↑ O'Brien KD, Kuusisto J, Reichenbach DD, Ferguson M, Giachelli C, Alpers CE, Otto CM (1995). "Osteopontin is expressed in human aortic valvular lesions". Circulation. 92 (8): 2163–8. PMID 7554197. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help)